Is 70 the new 50? Complications and outcomes of transjugular intrahepatic portosystemic shunt in older versus younger patients

• Published in: Abdominal radiology (New York) Vol. 46; no. 6; pp. 2789 - 2794
• Main Authors: Bisht, Roy U., Liu, Margaret C., Koblinski, Jenna E., Kang, Paul, Wong, Mark N., Little, Ester C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2021
• Subjects: Gastroenterology; Hepatology; Imaging; Medicine; Medicine & Public Health; Radiology; Special Section : Liver Transplantation; Cirrhosis; Complications; Liver; Age; Portal hypertension; TIPS
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-020-02533-3

Background
An increased risk of complications of TIPS in patients older than 65 years of age has been described, but data is limited. The objective of this study was to determine if the rate of complications post-TIPS differs in patients 65 or younger, compared to those older than 65 years of age.
Methods
A retrospective chart review was performed for all patients who underwent TIPS procedure at Banner—University Medical Center Phoenix, from 2010 to 2018, specifically focusing on complications and outcomes post-TIPS. In total, 402 patients were included in this analysis. Complications included portosystemic encephalopathy, post-TIPS infection, acute kidney injury requiring hemodialysis, hemorrhage, respiratory complications, need for transplant, or death.
Results
A total of 402 patients were included and divided into two groups: 300 (74.6%) were 65 years or younger (ages 53 ± 9), and 102 were older than 65 years (70 ± 5 (
p
 < 0.001)). There were no statistically significant differences between age groups when comparing portosystemic encephalopathy, post-TIPS infection, acute kidney injury, respiratory complications, need for transplant, or death.
Conclusion
In this large, single-center cohort, there was no statistically significant difference in the rate of complications of TIPS between the two age groups. Based on our results, TIPS procedure is an equally safe option for properly selected patients with complications of portal hypertension, regardless of age.